Volvulus of Left Descending Colon: A Case Report and Systematic Review

Abstract

Colonic volvulus has been described as the third most common cause of intestinal obstruction worldwide, with sigmoid volvulus representing more than 70% of all colonic volvulus. The descending colon is an atypical location for volvulus, with only a few documented cases in the literature. We report a case of non-viable left descending colon volvulus managed with left hemicolectomy in a 64-year-old male with no previous history of colorectal surgery. In addition, we conducted a systemic review of the literature for case reports of descending colon volvulus. We searched PubMed, Scopus, and Web of Science until November 2024 using the following search terms: (Volvulus AND “descending colon”). We extracted and summarized relevant data to better understand our case, and how it compares to previously documented reports. Our search yielded seven case reports that met our inclusion criteria. Our population consisted of four males and three females, with a mean age of 49.5 years and a range of (15 to 86) years. Most of our population was over the age of 30 (5/7). The most reported symptoms were abdominal distension, colicky or cramping abdominal pain, and vomiting. Left-sided colon volvulus is a rare cause of large bowel obstruction with variable and often atypical presentations, posing diagnostic challenges. Future research should investigate anatomical and clinical predictors of volvulus, optimize imaging modalities for early diagnosis, and evaluate long-term outcomes of various surgical approaches.